Can You Get SSDI or SSI Disability for Asthma?
Those who suffer from frequent and severe asthma attacks that can't be controlled with medication may get disability benefits.
Updated November 8, 2016
Asthma is a chronic disease of the respiratory system that involves inflammation of the airways. Asthma-related inflammation causes excessive mucous production within the airways, which results in constricted airways. Asthma is triggered by various stimuli, such as pets, medication, pollutions, chemicals, hormones, exposure to cigarette smoke, cold viruses, and other pathogens in the environment.
Symptoms of asthma include shortness of breath, wheezing, coughing, and tightness in the chest. Treatment of asthma may include the use of inhalers, nebulizers, medications, and simply limiting exposure to triggering stimuli when possible.
Asthma is a common reason that people apply for Social Security disability benefits. Most people who apply for disability based on asthma, however, are disappointed because they get denied. This is because asthma can often be treated effectively with medication. However, some patients do suffer from serious asthma attacks that can't be controlled with at-home medication or treatment. In these cases they are often admitted to the hospital for treatments with intravenous bronchodilators, intravenous antibiotics, or prolonged inhalation treatments. Patients with repeated, severe attacks requiring hospitalization should be approved for disability benefits because the frequency and intensity of their asthma attacks is severe enough to prevent them from working.
When Does Asthma Qualify for Disability?
If you can meet the qualifications under the Social Security's disability listing for adult asthma, your claim will be automatically approved. (For children, see our article on childhood asthma.) The asthma listing (which was significantly updated October 7, 2016) has two requirements:
- in a one-year period, you must have had three exacerbations or complications requiring hospitalization for at least 48 hours each. The hospitalizations must have occurred at least 30 days apart.
- your FEV1 value (the result of a lung function test) must be low for your age, gender and height (according to Social Security's chart in its asthma listing).
Alternatively, if you have chronic bronchitis in addition to your asthma (called chronic asthmatic bronchitis), you may be able to qualify for benefits based on the results of lung function/breathing test results alone. You must have the level of forced expiatory volume (FEV1) that is required for COPD (which is lower than that required for asthma alone). See our article on disability benefits for COPD to get the details on the test results required to qualify for disability for chronic asthmatic bronchitis.
What Should Be in Your Medical Record?
Your medical records should contain documentation of each of your asthma attacks that required hospitalization or emergency treatment, including spirometry test results and the results of arterial blood gas studies (ABGS) while you are in the hospital. The record of each episode should also include what treatment was administered, and for how long, and how well you responded to the treatment. Your doctor should also give you spirometric tests when you are not having an attack to record whether there is baseline airflow obstruction (established by FEV1 and FVC tests).
In addition, your medical records must show that you have been complying with the at-home treatment ordered by your doctor (for example, using your inhaler). (For more information, see our article on how compliance with treatment recommendations affect disability.)
The SSA will want medical records documenting your asthma attacks for at least one year, or the agency will wait until you have been evaluated for one year before issuing a disability decision.
Can You Qualify for Disability Because of Job Restrictions?
If you don't qualify for disability automatically under the asthma listing and you are an adult, Social Security will consider what limitations your asthma puts on your ability to work a regular job. Social Security will develop an RFC for you – that is, a residual functional capacity assessment, which is what you are able to do despite your impairment. If your doctor has restricted you from heavy exertion, working around excessive dust and fumes, or working in extreme hot or cold temperatures, Social Security will include these job restrictions in your RFC. These limitations can rule out a number of jobs that you can do, and if you prior job required any of the restricted activities, Social Security will have to come up with other work that you can do. If you're older than 50 or 55, you have a chance of getting disability benefits this way. For more information, see our section on how Social Security uses the RFC to decide what work you can do.